Organization
TOTAL RENAL CARE INC
Active
Other names
Lafayette Home Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
2 EXECUTIVE DR STE B, LAFAYETTE, IN 47905-4878
(765) 446-0603
(765) 446-3755
Mailing address
5200 VIRGINIA WAY, BRENTWOOD, TN 37027-7569
(615) 320-4514
(866) 594-9961
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300023250
—
IN
Enumeration date
07/02/2018
Last updated
12/18/2023
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